Individual
PHYLLIS JEAN PASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
100 E 77TH ST, NEW YORK, NY 10021-1850
(212) 434-2132
Mailing address
103 SCHOOL ST, PISCATAWAY, NJ 08854-5920
(732) 572-0572
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F304255-1
NY
Other
Enumeration date
07/06/2007
Last updated
07/08/2007
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